Updated: Sep 15
Patients who suffered childhood or adolescent anxiety and those who were born to parents with bipolar disorder are at an increased risk for developing bipolar disorder in adulthood.
A systematic review published in the journal Bipolar Disorder found evidence that the presence of anxiety disorders in childhood or adolescence increases patient risk for developing bipolar disorder (BD) later in life.
Investigators from King’s College London searched publication databases through September 2022 for longitudinal studies examining BD risk. A total of 16 studies comprising 21 reports with a total sample size of 2,433,761 study participants recruited from 10 countries were included in this review. The studies included patients who experienced anxiety in childhood or adolescence, as well as patients born to parents with bipolar disorder who also experienced early-life anxiety.
One study with 10 years of follow-up data for patients aged 14 to 24 years reported that the presence of obsessive-compulsive disorder and specific phobia increased the risk for BD onset by 590% and 120%, respectively. In addition, the study found a significant link between separation anxiety disorder and the later development of BD in a subsample of patients aged 14 to 17 years. The study included 4 years of follow-up data and reported that separation anxiety increased the risk for BD by 7-fold.
In addition, a study that employed a machine-learning approach using data from a large birth cohort reported that a diagnosis of suicidality, followed by generalized anxiety disorder by the age of 18 years were the first- and second-best predictors for BD risk, respectively.
"[T]his review suggests that anxiety in childhood or adolescence increases the risk of later bipolar disorder and may represent a clinically useful marker of vulnerability to major mood disorders in bipolar offspring."
In a study that assessed patients with hypomania spectrum episodes at ages 16 and 17 years, researchers found that the risk for developing BD at 15 years follow-up was associated with the presence of either a panic disorder or generalized anxiety disorder, either of which would increase BD risk by 12-fold.